Prognostic Role of Lung Ultrasound in Children with Bronchiolitis: Multicentric Prospective Study
Laura Gori, Antonella Amendolea, Danilo Buonsenso, Stefano Salvadori, Maria Chiara Supino, Anna Maria Musolino, Paolo Adamoli, Alfina Coco, Gian Luca Trobia, Carlotta Biagi, Marco Lucherini, Alberto Leonardi, Giuseppe Limoli, Matteo Giampietri, Tiziana Virginia Sciacca, Rosa Morello, Francesco Tursi, Gino Soldati, Ecobron Group
Abstract
There is increasing recognition of the role of lung ultrasound (LUS) to assess bronchiolitis severity in children. However, available studies are limited to small, single-center cohorts. We aimed to assess a qualitative and quantitative LUS protocol to evaluate the course of bronchiolitis at diagnosis and during follow-up. This is a prospective, multicenter study. Children with bronchiolitis were stratified according to clinical severity and underwent four LUS evaluations at set intervals. LUS was classified according to four models: (1) positive/negative; (2) main LUS pattern (normal/interstitial/consolidative/mixed) (3) LUS score; (4) LUS score with cutoff. Two hundred and thirty-three children were enrolled. The baseline LUS was significantly associated with bronchiolitis severity, using both the qualitative (positive/negative LUS p < 0.001; consolidated/normal LUS pattern or mixed/normal LUS p < 0.001) and quantitative models (cutoff score > 9 p < 0.001; LUS mean score p < 0.001). During follow-up, all LUS results according to all LUS models improved (p < 0.001). Better cut off value was declared at a value of >9 points. Conclusions: Our study supports the role of a comprehensive qualitative and quantitative LUS protocol for the identification of severe cases of bronchiolitis and provides data on the evolution of lung aeration during follow-up.